Part B of the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87) provides grants to U.S. states and territories. The AIDS Drug Assistance Program (ADAP) is a state and territory-administered program authorized under Part B that provides FDA-approved medications to low-income people living with HIV who have limited or no health coverage from private insurance, Medicaid, or Medicare. ADAP funds may also be used to purchase health insurance for eligible clients and for services that enhance access to, adherence to, and monitoring of drug treatments.
Part B grant recipients are the chief elected official of a state or territory who designates the state departments of health or other state governmental entities to implement and manage the RWHAP Part B grant. Part B grants are awarded to all 50 states, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, and the five U.S. Pacific Territories or Associated Jurisdictions.
- Congress designates a portion of the Ryan White HIV/AIDS Program Part B appropriation for the ADAP base.
- A formula based on the number of reported living HIV/AIDS cases in the state or territory in the most recent calendar year is used to determine ADAP award amounts.
- ADAP Supplemental funds are a five percent set aside of the ADAP base award which is for those states and territories that meet the eligibility criteria as outlined in the RWHAP statute and that choose to apply for additional funding to address a severe need for medication.
- The ADAP Emergency Relief Funding is a competitive grant intended for states and territories that can demonstrate the need for additional resources to prevent, reduce, or eliminate waiting lists, including through cost-containment measures.
Client eligibility is determined by the state and territory and includes financial and medical eligibility criteria. Financial eligibility is usually determined as a percentage of the Federal Poverty Level. Medical eligibility is a diagnosis of HIV.
- Clients must provide proof of current state residency.
- ADAPs are required to recertify client eligibility every six months and must meet HRSA's minimum requirements for recertification.
The RWHAP legislation requires that each ADAP must cover at least one drug from each class of HIV antiretroviral medications on their ADAP formulary. RWHAP funds may only be used to purchase FDA-approved medications. Within these requirements, each ADAP decides which medications to include on its formulary and how those medications will be distributed.
HRSA requires that ADAP eligibility criteria must be consistently applied across the state or territory, and that all formulary medications and ADAP-funded services must be equally and consistently available to all eligible enrolled people throughout the state or territory.